Limitations in the ability to assemble large population-based cohorts of patients with systemic and/or cutaneous lupus with validated diagnoses and with significant representation from previously underrepresented socio-demographic groups have been a significant barrier to better understanding the true clinical burden of lupus, as well as the many unanswered questions related to treatment, health care access, and natural history. The Georgia Lupus Registry (GLR) is one of two recently completed Centers for Disease Control and Prevention-funded population-based lupus registries designed to minimize many of these limitations. The Georgians Organized Against Lupus (GOAL) Cohort was born out of the efforts of the GLR to create a population-based prospective cohort of validated and consented SLE patients, reflecting real world lupus in the community in and around Atlanta, Georgia. Since its inception, 802 lupus patients have been consented and finished enrollment in the first year (2011-2012) and a total of 929 SLE patients by the end of the second year (2013). It is also uniquely positioned to create the largest population-based cohort of cutaneous lupus in the US. Our proposal is completely responsive to all of the special eligibility requirements of thi FOA and will utilize the established GOAL Cohort to prospectively collect important information and biological materials to serve as a repository for hypothesis generation and investigation by qualified research groups. This powerful and unique collection of patients followed over time will also provide an opportunity to explore important areas that were not possible before. Our proposal will utilize an established population-based lupus cohort to prospectively collect important information and biological materials to serve as a repository for hypothesis generation and investigation by qualified research groups. This powerful and unique collection of patients followed over time will also provide an opportunity to explore important areas that were not possible before. Specifically, we propose 2 projects that will explore how important and innovative components of social determinants of health interact with clinical, socioeconomic, and/or biologic factors to influence cardiovascular disease outcomes in systemic lupus erythematosus and quality of life in cutaneous lupus erythematosus as a way of understanding and addressing the significant racial health disparities that continue to exist. A third project wil use innovative laboratory platforms to test our ability to better predict those who are at highest risk of disease flares, potentially further mitigating disparities in the burden of disease. PHS 398/2590 (Rev. 06/09) Page Continuation Format Page